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- � THE �.1TY OF �VERE �i T �_� , � �, f;�� <br />Date�_� ��� <br />Sketch ot Proposed 5ewer Connection for Building Situated on Lot__ _ '"� _________ -- Block- _. �- - <br />I.. /_�� � , <br />Division or Addi:ion-._��e�,'+r .�; t �`_i , f ' �� �,_ / .�. � -- -��/�' �c t� - <br />�_ � <br />r . t ; , ` <br />No.--b=r�.a '_ 1� � i %I P L?r, ---Owned by- -Y'/��°'+�•-1-6_- �Z`�7: �r' _a_ _ --- <br />� .-s--------- <br />Application and Connection by_--1=� � �' ' �- � �� �' r � '� .•` l '=� -__-_____--__ _ Licensee <br />Rem�ks:—_—_�,�-� �i����'�' � --i--- - - --- - - --- --- <br />DeptL ot S��ier at Conneclion _ I J' . t! I � <br />J ��,•� r/r�7� `7�,..`f <br />�— � <br />, _ ,� <br />- �.�;�,,,;�,�._ `,: . ;._-, r�.. <br />f� ���:e.i" ���.,1� !' .._� <br />i <br />>.��-c:' .Z��.tc_•- . <br />.. �l . SJ. � ok�•.�_C; -.._. . <br />,� , <br />. -• �, ., � l�: .i �_. ��. ��c. _ � . <br />� — <br />�> -�{�- � <br />.) �. 1 a� r. <br />i� � <br />,� <br />Connection made the_ '�- f,-"_ _day oL __ <br />.�:A1�� l�"'� _ _. . <br />_ _ __-�, _,- f Y� - <br />�`.>, <br />By.. . L� . _ ., <br />� <br />I <br />� � �� <br />1 � ; -_,.- <br />��i� � t _ _ 19 �" � . Examined and Approved by_ -_�__„_ �� ' • ' '-= - <br />� City Enginecr <br />_ Sup�. of Stoeets and Sewere HY- � - - � � — — — <br />Inepoclor 19249 <br />